Bronchogenic carcinoma with lymphangitic spread

Case contributed by Dr Ahmed Abd Rabou

Presentation

Dypnea, productive cough and chest pain. History of old tuberculous inection

Patient Data

Age: 65 years old
Gender: Male

CT scout image reveals an ill defined opacity of the right parahilar region. CT images reveal an ill defined, irregular shaped spiculated soft tissue lesion occupying the anterior segment of right upper lobe. There is associated septal thickening, thickening and nodularity of the bronchovascular bundle and lymphadenopathies especially the right hilar, right lower paratracheal and subcarinal groups, some of them show calcification. Mild right pleuaral effusion is noted.

Diagnosis: Bronchogenic adenocarcinoma (pathology proved) with lymphangitis carcinomatosis

Annotated image

The red arrows refer to the spicules of the mass which indicate tissue microinvasion

The green arrows refer to the peribronchovascular thickening and nodularity

Case Discussion

Lymphangetic spread in the lung occurs with certain types of tumors including bronchogenic carcinoma, breast cancer, lymphoma and GIT malignancies. However they usually produce bilateral parenchymal lung changes. Only bronchogenic carcinoma can produce unilateral affection.

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Case information

rID: 29002
Case created: 26th Apr 2014
Last edited: 14th Mar 2016
System: Chest
Inclusion in quiz mode: Included

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